Your rights
No surprise medical bills.
What's balance billing?
When an out-of-network provider bills you for the difference between what your plan pays and their full charge. A “surprise” bill is one you couldn't reasonably avoid.
Emergency care
For emergency services — including stabilizing care afterward — you can only be billed your plan's in-network cost-sharing, even out of network.
At in-network facilities
Out-of-network providers at an in-network hospital (like anesthesia, radiology, pathology, labs or hospitalist care) can't bill you more than in-network cost-sharing.
When balance billing isn't allowed
You're only responsible for your share.
- You pay only the copay, coinsurance and deductible you'd pay in network.
- Your plan pays out-of-network providers directly.
- Emergency care is covered without prior authorization.
- What you owe is based on in-network rates and shown on your explanation of benefits.
- Amounts you pay count toward your in-network deductible and out-of-pocket limit.
You never have to give up these protections.
For non-emergency services, an out-of-network provider can only balance bill you if you agree in writing. You're never required to sign, and you can always choose an in-network provider.
Think you've been billed incorrectly?
Contact the federal No Surprises Help Desk.
Uninsured or paying yourself?
You have the right to a Good Faith Estimate of expected charges before your care.